Dr Cynthia Bearer

An impressive addition to the Children's Hospital was the successful recruitment of Cynthia Bearer, MD, PhD, as head of the division of neonatology and professor of pediatrics. Bearer came to UMMC one year ago from Rainbow Babies and Children's Hospital in Cleveland, Ohio. She is renowned for her expertise in fetal alcohol syndrome.

The Neonatal Intensive Care Unit (NICU), with at least 40 babies at almost all times, is one of the largest in the state. The skilled clinicians on this level IIIC unit use advanced technology and the latest evidence-based medicine to save the tiniest and sickest babies.

"We evaluate everything we do to care for these infants, making sure it is based on the best evidence, so that our care will give these infants the best chance to thrive," Bearer says. Sometimes, the techniques may be unfamiliar to parents, so communication is important in helping them know what's best for the baby.

For example, the NICU staff has incorporated a protocol for inducing hypothermia ”“ lowering the body temperature ”“ for 72 hours in full-term infants who suffered decreased oxygen or blood flow as the result of a difficult birth. This period of hypothermia reduces the extent of injury that can happen as a result of the returned flow of oxygenated blood to the infant's brain. Although cooling a newborn may seem counterintuitive to parents, Bearer says randomized, controlled clinical trials have shown the infants have the best outcomes when this method is used.

"It's just one example of looking at all of our practices, and asking which ones are based on the best evidence, and which are not," Bearer says.

Family-centered care is at the heart of the NICU: parents can be present any time of the day or night, as much as they want, whether to nurse the infants or gain skills in preparation for taking them home when they grow strong enough. Future plans are to expand the NICU by adding rooms that allow one infant and his or her family to occupy a room together, called "single-family rooms" or "rooming-in." This will help all infants, but it will especially help support the nursing mother and infant by allowing the mother to sleep in the same room with the baby.